FEELING FAT, FATIGUED AND FUZZY?
DO YOU MIND IF I ASK: "WHEN WAS THE LAST TIME YOU WENT #2?"

Every day in my practice I see men and women who say to me "Dr. Randolph, I am so tired that I hardly have enough energy to:

• play ball with my children
• fold the clothes
• read a magazine
• be intimate with my husband (wife)
• make a meal
• walk to the mailbox...

Now, if you have been reading my newsletter, you can probably guess that I do a complete hormonal work up on these patients including a checklist of symptoms associated with hormone imbalance, a saliva test to analyze hormone levels and a Life Event Profile to help understand how life stressors could be impacting health and hormone production. (Read my previous newsletter:Midlife Stress Can Make You Fat). What you might not guess is that I will also ask my patients to tell me about their bowel habits. It is very important that I know how often my patients eliminate waste from their bowels.

If you are feeling fat, fatigued and fuzzy, then it is also important that we discuss how often you go #2. Let me tell you why. In my practice, I often see a direct relationship between hormone imbalance, weight gain and sluggish bowels.

ARE YOU CONSTIPATED? ESTROGEN DOMINANCE COULD BE YOUR PROBLEM

Medical research and clinical studies indicate that constipation affects nearly 15% of the North American population, or 42 million persons in the U.S. alone. So, if you are not having regular bowel movements, you are not alone.

Constipation affects everyone, although it becomes more common as people age; women report constipation two to three times more often than men. This is due to the fact that hormones can affect bowel movements. For example, too little thyroid hormone (hypothyroidism) and too much parathyroid hormone (by raising the calcium levels in the blood) can cause constipation. Most physicians know this. Unfortunately, too many physicians do not connect the dots to realize that progesterone is an essential hormone that plays a critical role in healthy thyroid function. If progesterone levels are low, which they are for almost all women over thirty- five years of age, then thyroid hormone function may be impaired. When low progesterone levels impair thyroid function then bowel function almost always become sluggish. (For more information on how progesterone production is linked to thyroid function and weight gain... read my previous newsletter on Weight Loss)

Here's another often overlooked fact: high levels of estrogen can cause constipation. Who has high levels of estrogen? A lot of people. If you are a 35+ year old woman or a 40+ year old man and you are not on bio-identical hormone therapy, I would bet you do too. Let's see why.

There are several factors that can contribute high estrogen levels, or a condition of estrogen dominance. These factors include age, weight, stress and environmental exposure.

AGE AND ESTROGEN DOMINANCE

Let's start with understanding how a woman's age impacts estrogen levels. From the time menses begins until menopause, levels of estrogen and progesterone ebb and flow in a manner which promotes reproduction. At about age 35 to 40, women reach the time of premenopause, which is when their levels of progesterone and estrogen begin to reduce.

Normal Hormone Progression

During this time through age 50, there is a 35% drop in estrogen, but a 75% reduction in progesterone occurring simultaneously. This is normal, and does create many premenopausal symptoms that we accept as part of the aging process.

Many women in their mid-thirties, most women during premenopause, and even many women during menopause are overloaded with estrogen. At the same time they are suffering from progesterone deficiency because of the severe drop in physiological production during this period. There is then insufficient progesterone to counteract the amount of estrogen in our body. It is most noticeable among peri-menopausal women who do not ovulate, which is quite common. You may have a fairly normal cycle, but no egg is released and very little progesterone is produced.

It is not the absolute deficiency of estrogen or progesterone, but rather the relative dominance of estrogen and possible deficiency of progesterone that is main cause of health problems when they are not in balance. The end result: excessive estrogen relative to progesterone, add up to a condition John Lee, M.D. termed "estrogen dominance."

Men are also susceptible to estrogen dominance. If you are a man over 40 years of age, your testosterone production has already started to decline. If you also report feeling sluggish, bloated and lethargic these too are symptoms of hormonal imbalance.

Your age and your symptoms indicate that you are in the midst of male menopause, or andropause. If you tell me you suffer from a decreased libido and an inability to lose weight, I know that you are most likely also estrogen dominant in addition to being testosterone deficient.

WEIGHT AND ESTROGEN DOMINANCE

Weight loss research shows that, as soon as age causes hormone production to shift and estrogen dominance to result, the average person will add 1-2 pounds around their middle each year between ages 35 and 55. As long as the body's cellular metabolism is compromised by untreated hormone imbalances, most particularly estrogen dominance, those extra pounds around the middle will be next to impossible to lose.

Here's some more bad news about estrogen dominance: estrogen levels impact body fat distribution. In both men and women, higher estrogen levels predispose body fat to store around the abdomen. Estrogen dominance has also been linked to the fact that middle age women also tend to store more fat on their bottoms, hips and thighs.

STRESS AND ESTROGEN DOMINANCE

Stress causes adrenal gland exhaustion and reduced progesterone output. This tilts the estrogen to progesterone ratios in favor of estrogen. Excessive estrogen in turn causes insomnia and anxiety, which further taxes the adrenal gland. This leads to a further reduction in progesterone output and even more estrogen dominance. After a few years in this type of vicious cycle, the adrenal glands become exhausted. This dysfunction leads to blood sugar imbalance, hormonal imbalances, and chronic fatigue.

In the female, a large part of hormonal balance is controlled by the three major glands: the adrenal gland, the thyroid gland, and the ovaries. Maintaining a proper balance among these three glands is of critical importance in any estrogen dominance recovery program. Excessive estrogen affects both thyroid and adrenal function, and in turn, dysfunctional thyroid and adrenal fatigue makes estrogen dominance worse. They all go hand in hand. When not functioning properly, these three glands, controlling the majority of the hormones in the body, can lead to a viscous downward cycle of hormonal imbalance. Worse yet is that conventional medicine often times are mislead into treating symptom after symptom without addressing the root cause. A wide variety of prescriptions from sleeping pills to anti- depressants are dispensed. Unfortunately, such symptom-based protocol will often make things worse instead of better.

Also, the nervous system is very sensitive to stress. Constipation may be a direct result of changes in the nervous system during stress. Normal bowel movements are a result of complicated nervous system signals. Too much stress can cause an interruption of these signals that will affect many parts of the digestive tract. It can slow the intestinal movements that result in bowel movements.

ENVIRONMENTAL EXPOSURE AND ESTROGEN DOMINANCE

We are constantly assaulted by estrogens in our environment from the food we eat and the chemicals we use. Estrogen mimickers in the form of chemicals (xenoestrogens), and foods and plants (phytoestrogens), mimic the action of estrogen produced in cells and can alter hormonal activity.

Xeno literally means foreign, therefore xenoestrogens means foreign estrogens. Some of the 70,000 registered chemicals for use in the United States have hormonal effects in addition to toxic effects. The synergistic effects of exposure to many xenoestrogens are well documented, but largely unknown.

Xenoestrogens found in certain pesticides, plastics, fuels and drugs are usually synthetic and difficult for the body to break down, and can amplify the effects of estrogen. These substances can increase the estrogen load in the body over time, and are difficult to detoxify through the liver. Exposure to xenoestrogens is a concern for everyone. Those with an estrogen dominance condition should be particularly concerned about avoiding xenoestrogens.

Xenoestrogens can be found in many of our meats and dairy products in the form of chemicals and growth hormones that are given to the animals. These can be quite powerful, and should be avoided where possible.

Phytoestrogens (phyto meaning plant) are naturally occurring estrogenic compounds that are found in a variety of foods, herbs, spices. Their chemical structure resembles estrogen. These compounds are generally weak estrogens, in comparison to real estrogen and xenoestrogens, but in a body that is already experiencing too much estrogen, adding more will contribute to the problem.

Some of the strongest phytoestrogen containing substances are soy, the lignans found in flax seed products, red clover, black cohosh, chasteberry, and dong quai. Soy includes soybeans, soy milk, tofu, tempeh, textured vegetable protein, roasted soybeans, soy granules, miso, and edamames.

Over consumption of phytoestrogenic foods on a long term basis may actually increase the risk of estrogen dominance significantly. Furthermore, phytoestrogens have been shown to inhibit the conversion of T4 to the active T3 thyroid hormone, and can trigger hypothyroidism. Remember that you just learned how hypothyroidism, or too little thyroid hormone, can cause constipation.

"I AM BOTH ESTROGEN DOMINANT AND CONSTIPATED. NOW WHAT?"

If you have read this newsletter, believe you are estrogen dominant and experience frequent or intermittent constipation, here is what I recommend:

First, balance your hormones and neutralize your condition of estrogen dominance. Begin with my (Dr. Randolph's) Natural Progesterone Cream. Dr. Randolph's Natural Progesterone Cream contains the maximum concentration of human- identical progesterone that can be mixed in an over- the-counter (OTC) product. Many other OTC creams on the market today have a "little" progesterone in their mix but not enough to neutralize a condition of estrogen dominance.

In addition to using Dr. Randolph's Natural Progesterone Cream, I also recommend that you supplement your system with Calcium D-Glucarate. This particular supplement helps the body excrete excess estrogen through the bowel.

Also, Diindolylmethane is a phytonutrient found in vegetables including broccoli, brussel sprouts, cabbage, cauliflower and kale. Unlike other plant nutrients such soy isoflavones, diindolylmethane has unique hormonal benefits. It supports the activity of enzymes that improve estrogen metabolism. When taken as part of a healthy diet, DIM-Plus may help to support PMS symptoms, fat loss, healthy estrogen metabolism and regular bowel function.

In addition to immediately taking steps to balance restore your optimal hormone balance, I recommend that you sweep trapped toxins out of your colon. The elimination of undigested food is critical to your health. I firmly believe that most chronic diseases originate in some way in the colon. Waste ferments and rots when it remains in the digestive system for too long. That leads to proliferation of bacterial toxins that can trigger fatigue, headaches, foggy thinking and more.

To sweep those toxins out of your body, I recommend Renew Life Cleanse products. If this is your first time using an internal cleansing product, I would recommend First Cleanse. I trust this product because it is a complete, organic, internal cleansing program for first time cleansers. This gentle, two week, two part formula combines 39 whole herbs to support the cleansing of all 7 channels of elimination.

After you have used First Cleanse, I recommend Renew Life Cleanse: Daily Multi- Cleanse. It's the first and only internal cleansing formula designed for everyday use. This product's synergistic formulation blends 39 ingredients including 21 organic herbs and the highest quality nutraceuticals to support, enhance, and nourish the body's natural cleansing physiology. This master formulation is organic, gentle, non-laxative, and powerfully supportive for the body's 7 channels of elimination. Daily multi-Cleanse is the perfect way to cleanse everyday.

Now, you should be old and wise enough to know that no natural cream, supplement or cleanse will be enough to keep you healthy, happy and regular if you don't also drink plenty of water, eat well and exercise. I encourage my patients to drink lots of water to help flush the colon and, also, eat foods rich in fiber including fresh fruit and vegetables, whole grain cereals and breads, as well as dried fruit, such as apricots, prunes and figs. A fiber rich diet has a broom effect; it will sweep the walls of the colon to eliminate stagnant waste.

There are two types of fiber: soluble and insoluble. Soluble fiber dissolves in water and is degraded by bacteria in your colon. Soluble fiber forms a gel in your intestines which regulates the flow of waste material through your digestive tract. This type of fiber is found in fruits, oats, barley, psyllium and some beans. Soluble fiber is good for you but, no matter how much of it you eat, it won't influence your hormonal equilibrium.

Insoluble fiber, on the other hand, can directly impact your hormone balance by helping decrease estrogen overload. In addition to flaxseed and wheat bran, insoluble fiber is also found in beans, seeds and the peels of fruits and vegetables. It doesn't dissolve in water and passes through your digestive system largely unchanged. What insoluble fiber does do is bind to extra estrogen in the digestive tract. This extra estrogen is later eliminated in the body through the feces...or, "When you go #2."

I also tell my patients to "move your buns as much as you can". Physical activity nudges the bowels into action, so get up, move and do something you enjoy. Dance, stretch, run or wiggle. Whatever. Just walking for 20-30 minutes can be a simple and very effective exercise to encourage regular bowel elimination.

Finally, life is busy and everyone is subjected to a good bit of stress. Reducing life stress is a big goal. I suggest that you don't try to de-stress your whole world 24-7. If you are like me and most of the patients I treat, even the thought of that lofty ideal could make you break out in a sweat. I recommend taking a few baby steps each day to help you manage stress.

Find 20-30 minutes a day you can call your own. My personal favorite is reading pilot and flying magazines. I understand that my choice of free-time may not work for you. My wife tells me that, when she starts her morning journaling and reading inspirational books, she feels better all day long. I have several patients that tell me that their daily walks are their personal sanctuaries of peace. One patient told me she turns off her radio when in the car and counts her blessings. Another patient told me that he always plays 50's music when he drives, sings at the top of his lungs and always gets out of his car smiling. Again, whatever works. Just do something just for you. As an added benefit, your digestion and elimination might also improve.

In closing, when your hormones are in balance, everything from digestion to immunity works properly. You feel great, look great, have the energy of a teenager, and your libido is normal. Your body performs at its best. Isn't that what you want?

I am here to help. I wish you WELL!!!

- C.W. Randolph, Jr., M.D., R.Ph.

I am currently working with Genie James, M.M.SC. to develop the complete protocol and food plan for Dr. Randolph's "Waist Away" Hormone Balance Diet. If you are interested in knowing more about my diet program, please email your name and address to: CWR@HormoneWell.com.

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